Posterior tibialis tendon pain and dysfunction is a problem whose early diagnosis and treatment may prevent significant disability and surgery. Pain in the region of the medial maleolus and arch is sometimes difficult to attribute to a specific anatomical structure based on clinical exam, especially early in the course of posterior tibial tendon dysfunction. Therefore, many patients with posterior tibial tendon dysfunction may go undiagnosed. Magnetic resonance imaging (MRI) is the current standard diagnostic imaging technique utilized in the diagnosis of foot and ankle problems. Our study is designed to determine if there is a correlation between the clinical exam, ultrasonography, and MRI, and determine if MRI can be replaced with the less expensive and readily available ultrasound examination.